Artery Research

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Volume 24, Issue C, December 2018, Pages 84 - 84

P15 EFFECT OF UPRIGHT POSTURE ON CENTRAL WAVE REFLECTION IN 637 VOLUNTEERS NOT USING MEDICATIONS WITH DIRECT CARDIOVASCULAR INFLUENCES: DESCRIPTION OF DIFFERENT PHENOTYPES

Authors
Ilkka Pörsti1, 2, Matias Wilenius2, 3, Antti Tikkakoski3, Arttu Eräranta3, Manoj Kumar Choudhary3, Jenni Koskela3, Anna Tahvanainen3, 4, Jukka Mustonen3
1University of Tampere, Finland
2Tampere University Hospital, Tampere, Finland
3University of Tampere, Tampere, Finland
4Heart Hospital of Tampere University Hospital, Tampere, Finland
Available Online 4 December 2018.
DOI
10.1016/j.artres.2018.10.068How to use a DOI?
Abstract

Background: The effect of upright posture on the level of augmentation index (AIx) remains controversial [1–3]. Phenotypic differences in AIx responses to upright posture are unknown.

Methods: Altogether 323 women and 315 men without cardiovascular disease and medications with direct cardiovascular influences were subjected to passive head-up tilt (5-min supine, 5-min upright). Haemodynamics were recorded using continuous tonometric pulse wave analysis and whole-body impedance cardiography.

Results: Mean (SD) age was 45.6 (1.2) years, BMI 26.8 (4.4) kg/m2, and average blood count, plasma lipids and creatinine were normal. AIx decreased from supine 22.7% (11.9) to upright 13.8% (12.2) (p < 0.001), while heart rate related AIx@75 decreased from 17.9% (11.8) to 13.9% (11.0) (p < 0.001), respectively. In stepwise linear regression analyses, the explanatory variables for upright reduction in AIx were changes in ejection duration (β = 0.744), aortic reflection time (β = −0.491), and stroke volume (β = 0.117); and supine ejection duration (β=0.312), systemic vascular resistance (SVR) (β = −0.271), pulse wave velocity (PWV) (β = −0.203), and systolic blood pressure (β=0.081) (p≤0.001 for all). When divided to quartiles according to the supine-to-upright change in AIx 1) the quartile with lowest supine AIx had highest upright AIx, lowest supine SVR and PWV, and lowest upright heart rate; 2) the quartile with highest supine AIx had lowest upright AIx, highest supine SVR and PWV, and highest upright heart rate.

Conclusions: The level of AIx is decreased in the upright position. The phenotypic differences in the supine-to-upright change in AIx may explain why this variable has not predicted cardiovascular events in all endpoint studies.

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This is an open access article distributed under the CC BY-NC license.

References

1.B van den Bogaard, BE Westerhof, H Best, et al., Arterial wave reflection decreases gradually from supine to upright, Blood Press, Vol. 20, 2011, pp. 370-375.
2.SC Davis, BE Westerhof, B van den Bogaard, et al., Active standing reduces wave reflection in the presence of increased peripheral resistance in young and old healthy individuals, J Hypertens, Vol. 29, 2011, pp. 682-689.
3.WE Hughes and DP Casey, Aortic Wave Reflection During Orthostatic Challenges: Influence of Body Position and Venous Pooling, Am J Hypertens, Vol. 30, 2017, pp. 166-172.
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Journal
Artery Research
Volume-Issue
24 - C
Pages
84 - 84
Publication Date
2018/12/04
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2018.10.068How to use a DOI?
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

risenwbib
TY  - JOUR
AU  - Ilkka Pörsti
AU  - Matias Wilenius
AU  - Antti Tikkakoski
AU  - Arttu Eräranta
AU  - Manoj Kumar Choudhary
AU  - Jenni Koskela
AU  - Anna Tahvanainen
AU  - Jukka Mustonen
PY  - 2018
DA  - 2018/12/04
TI  - P15 EFFECT OF UPRIGHT POSTURE ON CENTRAL WAVE REFLECTION IN 637 VOLUNTEERS NOT USING MEDICATIONS WITH DIRECT CARDIOVASCULAR INFLUENCES: DESCRIPTION OF DIFFERENT PHENOTYPES
JO  - Artery Research
SP  - 84
EP  - 84
VL  - 24
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2018.10.068
DO  - 10.1016/j.artres.2018.10.068
ID  - Pörsti2018
ER  -